Young flood survivors in Pakistan face an uphill struggle against malnutrition

By Ban Al-Dhayi and Vivian Siu

MINGORA, Pakistan, 13 October 2010 – Last month, Najma Syed Ali Khan, 19, brought her seven-month-old daughter Rukhsar to the Nutrition Stabilization Centre at Saidu Teaching Hospital here in the Swat district of north-western Pakistan. Distressed and confused, Najma learned that the baby was not only severely malnourished but also suffered from gastroenteritis.

VIDEO: UNICEF correspondent Vivian Siu reports on the nutrition challenges facing children and women in the aftermath of the monsoon floods in Pakistan. Watch in RealPlayer

Unable to breastfeed, Najma received milk from the centre to feed Rukhsar, who had been surviving on black tea and cow milk in the aftermath of this summer’s severe monsoon floods.

Rukhsar weighed only 3 kilograms when she was admitted to the nutrition centre. An infant at her age normally weighs 7.6 kilograms. “She’s severely wasted,” said nutritionist Adil Rehmat Gul at the hospital’s paediatric unit. ”She needs extraordinary support to make it through.”

Uprooted by violence and floods

In 2009, Najma and her husband fled with Rukhsar older sibling after fierce fighting broke out between militants and government forces in Mingora, their hometown. “We kept roaming about the plains for three months before finding a haven in the Swabi camp,” she said. “Only in June of this year were we able to go back home.”

© UNICEF Pakistan/2010/Zak
Severely wasted Rukhsar Syed Ali Khan, seven months old, sips milk in the UNICEF-supported Nutrition Stabilization Centre at Saidu Teaching Hospital in Swat district, north-western Pakistan.

But this summer, the Syed Ali Khan family was violently uprooted again – this time by the massive floods that washed away the family’s home and all of their belongings. Najma and her family found themselves displaced yet again. Now they are staying with relatives who live hand-to-mouth.

Even before the floods, Pakistan’s infant mortality rate was one of the highest in South Asia. Nearly 1 in 10 children here do not survive to their fifth birthday, with the majority of deaths due to diarrhoea, pneumonia or vaccine-preventable diseases, combined with inadequate hygiene, sanitation and feeding practices. Almost 40 per cent of children under five are underweight and lack household sanitation, especially in rural areas. More than a quarter of children are born with low birth weight.

Now, the flood damage to crops and agricultural infrastructure is having detrimental consequences on food availability. It is very likely that child nutrition will remain at risk for a long time in flood-affected areas.

Averting a nutrition crisis

“While responding to the urgent situation with life-saving interventions, it is critical to set medium- and long-term measures to stave off an impending crisis,” said Dr. Noel M. Zagré, Senior Emergency Nutrition Specialist at UNICEF’s Asia-Pacific Shared Services Centre. Dr. Zagré is lending his expertise in Pakistan, giving guidance to partners on the steps they should take to help children and women in Pakistan who are in dire need of food.

© UNICEF Pakistan/2010/Dhayi
Najma Syed Ali Khan, 19, feeds her severely malnourished daughter Rukhsar at Saidu Teaching Hospital, Swat district, north-western Pakistan.

To help avert a nutrition crisis, UNICEF supports 30 nutrition stabilization centres across Pakistan, and work is under way to scale up this number in flood-affected areas. The centres provide 24-hour service for severely malnourished children who also suffer from other health complications.

Meanwhile, more than 300 doctors, nurses and others have been trained in the implementation of a programme focused on community-based management of severe acute malnutrition. Approximately 3,000 severely malnourished children have been admitted into the programme and are currently being treated.

UNICEF is also working to meet the supply needs of all its implementing partners in order to provide timely and adequate treatment for malnourished children. Therapeutic paste and milk, supplementary food, high-energy biscuits for pregnant and lactating women and their children, in-patient kits, anthropometric kits and essential medicines – all have been dispatched in areas devastated by the floods. 

Aid for the most vulnerable

Children, especially those under the age of two, are most vulnerable to the impact of malnutrition, which, in turn, makes them more susceptible to life-threatening illnesses. It is critical that nutrition concerns be tackled now, as families in Pakistan try to recover from the flood disaster.

© UNICEF Pakistan/2010/Dhayi
A severely malnourished child eats Plumpy'nut, a therapeutic food paste, in the UNICEF-supported Nutrition Stabilization Centre at Saidu Teaching Hospital, Swat district.

While young Rukhsar avails herself of a lifeline provided at a critical time in Swat, there are millions more children in Pakistan whose dietary requirements have been overlooked amidst successive emergencies – a situation exacerbated by many caregivers’ poor awareness of proper feeding practices.

In the month since Rukhsar was admitted to the Nutrition Stabilization Centre, her weight has increased by 0.6 kilograms, and her gastroenteritis condition has been mitigated. If support centres like the one that has helped her are not maintained and expanded, experts estimate that over 125,000 Pakistani children could suffer from dangerous levels of malnutrition in the coming year.



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